Organization
EL VIGNOBLE,LLC
Active
Other names
Medix Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SINIKIWE CHIWARA RPH (OWNER)
(954) 530-4793
Entity
Organization
Contact information
Practice address
4850 WEST OAKLAND BLVD, SUITE 106 & 108, LAUDERDALE LAKES, FL 33313
(954) 696-3641
Mailing address
4850 WEST OAKLAND BLVD, SUITE 106 & 108, LAUDERDALE LAKES, FL 33313
(954) 530-4793
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23858
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000623300
—
FL
01
—
1039266
NCPDP
FL
Enumeration date
09/03/2008
Last updated
08/28/2009
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